Govt urged to emulate Tata Memorial Centre's hub-and-spoke cancer care model across India

Tata Memorial Centre (TMC), a grant-in-aid institute under the Department of Atomic Energy (DAE), has suggested that the government emulate its hub and spoke model of cancer care and establish 30-40 hub centres that can serve approximately 5-7 crore people each to provide full range of cancer care to patients across India.

In its response to the Parliamentary Standing Committee on Science & Technology, Environment, Forests and Climate Change, which reviewed the functioning of TMC, the country’s premium cancer care provider said TMC’s existing 7‑state network proves the concept, but nationwide rollout will require much broader participation and the expansion of cancer hub-and-spoke model should build on existing public health institutions.

TMC has already established a network of 12 cancer hospitals in Mumbai, Varanasi, Visakhapatnam, Sangrur, New Chandigarh, Guwahati and Bhubaneswar which together handle over 1,30,000 new cancer patients annually, making it one of the busiest groups of hospitals globally. Stating that covering the entire country through TMC’s networks of cancer hospitals would not be feasible, TMC informed the Parliamentary Panel that it has submitted its proposal to several parliamentary committees urging scale‑up in partnerships with Central and State Departments of Health.

In fact, the Central government’s ongoing National Programme for prevention and control of NCDs (NP-NCD) already envisions a two‐tier hub‑and‑spoke cancer network. Under this scheme, State Cancer Institutes (SCIs) serve as regional hubs, and approved Tertiary Care Cancer Centres (TCCCs) act as spokes providing specialist care to surrounding district hospitals and medical colleges. District NCD clinics and day-care centres become sub-spokes for diagnosis and basic treatment. The suggestion is to see that all existing SCIs, RCCs and major centres like All India Institute of Medical Sciences (AIIMS) be upgraded or designated as hubs/spokes based on their infrastructure. Thus the entire public cancer care network (AIIMS, RCCs, SCIs, medical colleges, district hospitals) will be knitted into a nationwide hub‑and‑spoke framework.

In its earlier submissions to parliamentary panels, TMC has given detailed budget estimates for model hubs and spokes, including capital costs and staffing needs also. According to such submissions, a model hub (300 beds, fully equipped for advanced cancer care) would require about Rs 650 crore in one‑time capital investment, and about Rs 110–120 crores per year in recurring costs. A model spoke (100 beds, handling common cancers) would need around Rs 400 crore capital and Rs 35–40 crore annual running costs.

The Parliamentary Standing Committee on Science & Technology, Environment, Forests and Climate Change has now recommended TMC to become the ‘national technical partner’ and collaborate with the States and provide requisite guidance, mentorship, workforce training, and standardized clinical protocols required to deliver specialized cancer care.

In India, 1.57 million new cancer cases are estimated to get reported annually. However, the country does not have a nationwide, population-based cancer registry and the existing cancer registries together cover only about 19% of the country’s population.